Complications
by ggo85
Summary: McCoy struggles with a seriously injured Pike and his new role as CMO.
1. Emergency

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and try to return them intact

Thanks to Ceri for the great beta; mistakes are mine alone.

___________________________________________________________________________________________________________________________________________________

Medical emergencies were the same, Leonard McCoy decided, whether in the trauma center of Atlanta's largest hospital or millions of miles into space.

He rushed through the Enterprise corridors toward the transporter room prepared for the worst. Pike had spent over a day on the Romulan vessel in the clutches of Nero and his henchmen – more than enough time for them to inflict serious damage on the _Enterprise_ captain. Not to mention that Jim himself could well be injured – he hadn't been in the best shape when he'd transported _to_ the Romulan ship and a visit with the enemy probably hadn't improved his condition.

Kirk's cryptic message had only requested an immediate beam-out and for a medical team to meet them in the transporter room. No mention of the type of injuries or the severity. Or even who was hurt.

McCoy skidded into the room in time to see Pike collapse in Jim's arms. His medical team quickly took over, easing Pike onto the stretcher. No obvious injuries, but internal damage was often the worst.

Playing a scanner over the Captain's barely conscious form, McCoy barked orders as he made his assessment. He didn't need any instruments to see the man was in pain. "50 milligrams Tencefladine."

A hypo was immediately pressed against Pike's neck, reducing his heart rate and sinking him into unconsciousness. "We're gonna need neurogenic stimulators and—" McCoy frowned as his scanner locked onto a small dark shape pressed against the Captain's spine. What in the hell was that? If he didn't know better, he'd swear it was . . . the hand scanner lacked the precision of his medical bay instruments, but it sure looked like . . . some sort of a tarantula. What was that thing doing in Captain Pike's back and how in the world did it get there?

He gestured for the medtech to help roll their patient onto his side. Pushing up Pike's shirt, McCoy examined his back for evidence of an entrance wound. Nothing. Weird. But this wasn't the time or place to figure out the mystery.

"Ok, folks, let's go." He turned to the transporter tech. "Call medical and tell them to prep for surgery." McCoy looked around for his other patient, but Jim, aka Acting Captain Kirk, was long gone. If Jim was fit enough to flee the transporter room, McCoy thought, he was in a lot better shape than Pike. For now, that would have to be good enough.

****************************

The trip to the medical bay was short and once there, Pike was transferred to a biobed, stripped of his clothes, and covered with a sheet. Techs and nurses hooked up monitors and dutifully recorded the information they produced. It seemed everyone wanted to help; Pike was popular among the crew and McCoy found himself ordering several of the medical staff away from the bed to allow him room to work.

He was anxious to start what he expected would be a long and complex surgery. First, however, he needed to get a better sense of Pike's condition, starting with that thing in his back, something none of his staff had yet seen.

"Give me a shot of L1 through L3 with the hi-res," he ordered. A medtech adjusted the equipment to zoom in on Pike's lower spine. Above the bed, a detailed projection revealed that the black mass was definitely a creature, an arthropod that the sophisticated diagnostic equipment wasn't able to match to a known species. Studying the image, McCoy decided that his initial impression of an oversized tarantula wasn't far off. Suddenly the creature shifted and a tentacle stretched itself more tightly around Pike's spinal cord.

Across the bed, a gasp emerged from his nurse. "Oh, my God."

McCoy glanced sharply at her. "Collins, pull yourself together or get someone else in here." Without waiting for a response, his eyes returned to the screen. "Torrance," he summoned the medtech with a nod, "take an image and search the science library. We've got to figure what that thing is."

"Looks like he was beaten up a bit, some abdominal trauma," another technician reported after completing a full body scan, "but no serious contusions or abrasions and no entry or exit wounds."

Well, that was good news, to an extent. Still, that thing wrapped around the spinal cord was a major problem. The Romulans had put that creature in Pike's body for a reason and that meant getting it out was priority number one.

"Doctor McCoy." Nurse Collins pointed to another section of the scan. "Look at the scarring in the esophageal region."

"Damn." On the screen, McCoy traced the scarring through the digestive track. So that's how the creature had entered Pike's body. The thought made him sick to his stomach. Emergencies might be emergencies, but they sure didn't make them like this in Atlanta.

His eyes critically scanned the monitors which stubbornly refused to stabilize. Something was playing havoc with Pike's entire metabolism. Heart rate, blood pressure, temperature – Pike's values were jumping all over the place despite the medications he'd been given. The sooner that creature was out of his system, the better. It was time to get started.

"Okay, folks. I want him ready in five minutes. Collins, you and Beckworth will assist. I'll start with a posterior midline incision." He turned toward the changing room. "And make sure we have a container to hold that thing when we get it out."

As he held his hands under the Sterilite, McCoy thanked Mr. or Ms. or Dr. or whatever Cartajena-Pena – the wonderful soul who'd invented a sterilizer that did in less than fifteen seconds what used to take surgeons at least that many minutes. The tedious scrubbing with harsh brushes and abrasive soap was now relegated to the history books.

A surgeon by training, McCoy had learned and then honed his skills as a surgical resident in Jackson, Mississippi and then cleaning up gang violence in Atlanta. Not many surgeons arrived at Starfleet Academy with well over a decade of experience under their belts. Of course, not many men his age were looking to start a career in Starfleet – no, they were home with their families enjoying a suburban existence, not having their molecules scattered throughout the universe and pulling large spiders out of their patient's spines.

At Starfleet, the medicine had come easily, even on species new to him. It was all of those damned rules and regulations that drove him nuts. He could wield them to his advantage – as he'd done in sneaking Jim onto the Enterprise – but he generally found them an impediment to what he really wanted to do, which was to practice surgery and save lives. Now was his chance to do just that and on no more important patient than his commanding officer.

Across the surgical table, his two nursing assistant stood ready. The death of the Enterprise's original CMO, Dr. Puri, left him as the only physician, let alone surgeon, aboard the Enterprise. In its infinite wisdom, Starfleet saw no reason to provide more than two doctors for a crew of 500 incredibly healthy young men and women. That made perfect sense, McCoy thought, until one of those doctors was killed and the crewmen were no longer quite so healthy.

McCoy gave the monitors another glance – Pike was as stable as he was going to get. "Let's get started." Collins handed him a laser scalpel – a number six.

McCoy bit his lower lip, looked heavenward, and did his best not to groan. "I always use a five-blade to open." Of course, the laser scalpels didn't have blades, per se, but the terminology persisted. And, of course, Collins had never worked with him before, so it wasn't surprising that she didn't know his preferences. Still, the surgery would be complicated enough without having essentially to train an assistant as he went.

"I'm sorry, sir." Collins quickly placed the correct instrument in his hand.

McCoy was about to tell her not to worry about it, not to call him "sir," and about to make the lengthy incision, when suddenly the deck seemed to fall out from under him. "What the hell—" He grabbed for a handhold, scalpel flying out of his hand. He held on tightly, just like he'd been taught at the Academy – the first one's only the beginning, his instructors had said. There was a brief shudder, another jolt. More instruments went flying. Pike, firmly secured to the table, seemed to be the only one – or thing – not tossed aside.

Shit! Was the ship under attack? Having already experienced one battle with the Romulans, he didn't think so – the ship's movements felt different and, besides, there'd been no word from the bridge on expecting casualties. Speaking of the bridge, what in the world was Jim doing up there? How was McCoy supposed to stand up, let alone perform delicate neurosurgery under these conditions? For now, they still had the artificial gravity – if that went . . . . The ship rattled again and his grip on the handhold tightened. There was a Starfleet Medical protocol for this – he was sure he'd memorized it and probably practiced it more than a hundred times, but for the life of him he couldn't remember step one.

"Stability control!" Collins called out. The OR shuddered slightly then seemed to stabilize. He'd momentarily forgotten that the OR could be isolated with gravitational sensors that automatically steadied the room despite the shocks to the ship. The result wasn't perfect but it was a heck of a lot better than a few minutes ago.

"Beckworth, need a new surgical tray and find someone to clean up this mess," Collins called out. A moment ago, she'd seemed terrified and unsure of herself; now she was more in control of the situation than the ship's acting CMO.

For a moment, McCoy considered calling the bridge to tell Jim to stop shaking this ship around, then thought better of it. Jim more than anyone knew about Pike's condition – if the ship was being tossed like salad, there was obviously a good reason for it. McCoy's responsibility was his patient. Time for him to stop quaking like a scared cadet and start acting like a surgeon. Jim and the Vulcan would have to take care of the rest.


	2. Hands of a Surgeon

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

On the _Enterprise_ bridge, Jim sank into the captain's chair thinking not for the first time that it could use a bit more padding. Now that the immediate crisis with Nero was over, and the Romulan captain and ship were part of oblivion, the various bumps, bruises and cuts that covered his body were making themselves known. He shifted in his seat to take some of the pressure off his right hip which ached terribly. On his periphery, he saw Spock's eyes narrow. The Vulcan seemed to be deciding whether to speak up.

"Mr. Sulu," Kirk announced, preempting any such attempt. "Time to nearest Starbase?"

"If we maintain our present speed, approximately nine days, four hours to Starbase 14, sir."

"Any chance of increasing our speed?"

It was Spock's turn. "Mr. Scott advises against it, sir. Jettisoning the warp core limits us to space normal speed. In order to have a safety margin—"

Jim's head was killing him. "I got it. Make your best speed under the circumstances. Head for Starbase 14."

"Captain." It was Spock again. "Starbase 14 has fairly primitive medical facilities by Starfleet standards. I recommend Starbase 17 – transit time is only an additional 43.62 hours and its offers significantly advanced medical services. It may be prudent to consult with Dr. McCoy on the subject."

Had Spock subtly picked up on his physical pain, his comment a veiled suggestion that he himself seek medical treatment? The Vulcan's expression, however, remained impassive.

This probably wasn't the moment to call Bones, who certainly had his hands full caring for Pike. "I'd rather not bother him now. Let's head for Starbase 17; we can always change course after we speak with McCoy."

At his station, Spock nodded, apparently satisfied with the decision. "Sir—" Spock seemed to hesitate.

"Yes, Mr. Spock. What is it?"

"If you'd like to go to the Medical Bay – to check on Captain Pike . . ."

Yeah, Spock was definitely trying to tell him something. "I don't think Bones would appreciate my hovering," he replied with a tight smile. _And, the last thing I need is to be in the doctor's clutches_.

He leaned back in his chair, forcing himself not to wince as his thoughts went to McCoy. Captain Pike's life now rested in his hands, literally. Pike had put up a good front while being rescued but Kirk suspected it was just that – a front. Even he could see that the time spent with Nero had taken its toll – Pike would never have allowed himself to collapse in front of Kirk and Spock if there had been any way to remain on his feet. Jim had made good on his promise to rescue the Captain; now the challenge passed to Bones to patch him up.

So how good was McCoy the surgeon? He really had no idea. They'd been in the same Academy class, but there might as well have been a universe between them. Command cadets and medical personnel rarely mingled professionally and thus he had only the vaguest idea what McCoy did or whether he was any good at it. In fact, he was pretty certain that Bones had a far better sense of his command abilities than he did of the doctor's surgical skill. Sure, Bones had patched him up after drunken brawls, Academy boxing matches, and other times when he'd returned to the barracks with assorted cuts and scrapes and refused to go to Medical. But patching up cuts and scrapes wasn't the same as dealing with whatever had crippled Pike.

He took solace in the fact that Starfleet didn't accept dummies and, unlike many Starfleet doctors who earned their MD degrees at Starfleet Medical, Bones had already been a surgeon when he stepped aboard that transport three years ago. He must have worked on his own many times, treated and saved many patients. And Pike, who was no one's fool, had handpicked him for the _Enterprise_.

Still, this wasn't some unknown patient in Atlanta. This was Captain Pike, the man most responsible for James T. Kirk being in Starfleet. Thanks to Pike, he wasn't stuck in a dead-end job or worse, in a penal facility. He'd risked his life to save Pike and would do it again in a heartbeat. Now, however, whether Pike lived or died, whether he'd ever again be Captain of the _Enterprise_ – depended on the skill of Bones McCoy.

******************

McCoy's surgical technique was swift and efficient as he worked to expose Pike's spinal cord. Collins had turned out to be a better assistant than he'd expected, and it didn't take long for her to start anticipating his commands. McCoy prided himself on his ability to remain calm and collected during even the most taxing surgery. Just as a ship's captain in the heat of battle, it was critical for the chief surgeon to remain focused and unemotional while the battle for life raged beneath his fingers.

Right now, though, the inability to keep Pike's vital signs stable was wearing on him. Normally, machines monitoring the patient would automatically compensate for the normal changes that occurred during trauma surgery, providing pre-ordered doses of medication to deal with any irregularities. However, the huge fluctuations in Pike's bodily functions caused the monitors to alarm with regularity and forced McCoy to make constant adjustments to the medications and dosages. The process was annoying, frustrating, and stealing attention from the surgery at hand.

"Blood pressure's spiking," Collins reported. "240 over 120."

"Goddammit—" Bones swore softly. Twenty minutes ago, the pressure had plummeted. Now it was skyrocketing. "Hyroxidine."

"How much, Doctor?"

"Let's start with 40 mg." He kept his eyes on the surgical field and reached out a free hand. "Give me some retraction and a number three probe."

The retractors carefully pulled apart another layer of skin, exposing Pike's spinal cord as well as the creature that entwined it. McCoy's eyes narrowed; he'd seen a lot of strange objects inside the human body, but this was definitely a first. As he watched the thing seemed to shrink away, pulling itself to the underside of the cord. Double dammit.

"Pressure's coming down," Collins reported, "but still 180 over 110."

Another alarm went off. Pike's respirations were now dangerously low. He stole a glance at the monitors, mentally calculating the combination of meds that would lower BP and raise respirations without causing some other problem.

"Give him a 200 cc bolus of Lebutol and start a flow at 100 cc per hour. Increase the Hyroxidine to 60 mg." His attention returned figuring out the best way to remove the creature from Pike's body. Should he kill it or try to extract the thing while it was still alive? Keeping it alive would help him analyze it and its affect on Pike. But the effort could cause the creature to do any number of things which, given its proximity to Pike's spinal cord, were all likely to be bad.

Taking a deep breath, McCoy wished not for the first time that the "real" CMO were here. In civilian practice, there was always another surgeon across the table or in the next OR who could be called on for advice. Here, he was on his own. The decisions he made in the next few minutes could well mean the difference between Pike having or not having a neurological deficit or even between living and dying. There were reasons they paid CMOs the big bucks, figuratively speaking of course, and this was one of them.

"Pressure's falling. Fast," Collins added.

"Ease up on the Lebutol and have some Colazine standing by."

The medtech's voice sounded over the intercom. "Torrance to Medical. Dr. McCoy, I think I've found it. I think that spider is a Romulan arthropod, called a lichant--, licant—"

"Dammit, I don't care what it's called. I want to know what happens if I touch it – and how to kill it."

"Yes, sir. Our database is incomplete but it seems the thing is sensitive to light and cold. It doesn't say anything about being harmful outside of the human body."

McCoy mentally blasted the scientist who wrote this garbage without telling him what he really needed to know. "Does it bite?" he asked.

"Bite, sir?"

"Yes, you—" Calling his subordinate a moron probably wasn't a great start to his CMO career. He took a calming breath, just like they'd taught during residency. "When I touch it to remove it," McCoy spoke very slowly enunciating each word, "will the blasted thing try to bite me?"

"Uh, I don't think so, sir."

He didn't think so. Great. Just fucking great.

McCoy looked into the surgical field. Sensitivity to light – that explained why the thing had shrunk away when exposed to the harsh OR lights. It was the sensitivity to cold, however, that gave him an idea. Maybe he could try something between killing it and pulling it out alive and kicking. Even better, something that might keep him from being bitten.

McCoy allowed himself another deep breath. "Give me a number two cryoprobe."

***********************

As a surgeon, McCoy was about good as they came and he knew it. Maybe that's why he and Jim got on so well. Surgeons and starship commanders shared a certain level of self-confidence, a trait some might describe as cockiness. But it was also necessary – who wanted a surgeon or CO for that matter who considered himself just "okay" in terms of skill level? A smile creased his face, then instantly faded. The surgery on Captain Pike required total concentration. Another monitor alarmed and he gave another order of medication to compensate. He wasn't sure how much more of this Pike – or he – could take.

The intercom crackled. "Kirk to Medical."

McCoy ignored the call as he carefully dropped the creature into a waiting container. Touching it with the icy probe had done the trick – freezing the creature literally and figuratively and allowing him to remove it without additional damage to Pike's spine. The thing appeared still to be alive; outside of Pike's body that state might not continue for long. No real loss.

"Doctor." It was the medtech. "Captain, uh, Acting Captain Kirk wants to speak to you."

_I'm a little busy here_, McCoy thought to himself. However, it was understandable that the _Acting_ Captain wanted an update on the condition of the _permanent_ Captain. "Transfer it in here," he called out.

"Bones, how's Pike?"

"He'd be better if I could focus on his surgery and not you," he replied, irrigating the wound to ensure all traces of the arthropod were removed. "He's having a rough time of it. I'll call you when I'm done. McCoy out."

Jim probably wasn't too happy with the short report or that he'd unceremoniously cut him off. Too damn bad; he had work to do. It was time to close the spinal incision and start repairing the intestinal damage. He held out his hand. "Protoplaser."


	3. Another Crisis

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

Jim, trailed by Spock, strode into the medical bay moments after McCoy had sent word that Pike's surgery was finished. Bones hadn't provided further details, which Jim took as an ominous sign.

Medical was dark and quiet except for the occasional hum of the automatic monitors. Jim passed the beds of several crewmen still recovering from the Romulan attack. Most were asleep, machines above their beds keeping silent watch.

One injured crewmember who was awake smiled as he approached. It was with a strong sense of embarrassment that Kirk realized he didn't even know her name. Her lower arms were covered with severe burns, a casualty of Nero's attack. They looked terribly painful but, judging from her relaxed demeanor, the painkillers McCoy had obviously prescribed were just as obviously working.

"Lieutenant Akila," Spock's voice came from behind him. "Your presence has been missed in the xenobiology lab."

Great, Spock knew her name and where she worked, while he could only stare blankly. Jim realized he needed to study photos and memorize job descriptions of what was, for the time being at least, his crew. It was poor form for a ship's captain not to know his subordinates by name, rank, face, and job, and he had little idea as to the identities of anyone other than the bridge crew.

It probably would have been an even better idea if he'd made an effort to visit the crewmembers still in the Medical Bay before now. He'd let his own desire not to be examined by McCoy interfere with his duty to comfort those who'd been injured in battle. Damn, there were so many things to remember in this command thing.

Akila was still smiling – dang those must be good meds Bones handed out. "Thank you, Mr. Spock." She nodded in the direction of her burns. "Dr. McCoy says he'll start the grafting and regeneration tomorrow and that I'll probably be back to work in a week."

"We will all look forward to it, Lieutenant," Spock replied smoothly.

"Yes, definitely," Jim added. Oh that was good. He smiled at her, feeling like a heel for being so clueless. When she nonetheless returned his smile, he nodded and swiftly excused himself, heading in the direction of the isolation room, where McCoy, still in his surgical attire, was working over Pike and clearly agitated. Warning bells started to go off in Kirk's head. A glance at Spock revealed he too seemed . . . concerned.

Pike lay pale and motionless under a sterile sheet, his body suspended a few inches above the biobed in a position designed to relieve pressure on the spinal region. Jim moved closer, being careful not to touch any of the tubes and lines snaking between Pike's body and the medical machinery. Rather than attempt to interpret the monitors, he decided to await McCoy's pronouncement.

"Bones?" he asked tentatively.

McCoy turned toward him, the strain of the past few hours etched onto his face. "Well, surgery's over, but he's still critical and I can't say he's exactly stable." He turned back to his nurse. "Call me if anything changes. And I mean anything."

He nodded at Jim and Spock. "Come with me."

Jim started to say something about giving orders to the Acting Captain and First Officer but one look at Bones' expression made him think better of it. Instead, with a shrug directed at Spock, he followed his acting CMO out of the room.

McCoy led them to the CMO's office, still outfitted for its recent and now deceased owner. The nameplate, plaques, diplomas and awards all bore Dr. Puri's name, and the tchotchkes lining the cramped shelves undoubtedly belonged to the former CMO as well. Bones had carved out a corner of the desk for his own belongings that had the disorganized clutter of a temporary resident.

"Be right with you," McCoy said as he gave instructions to his computer to monitor Pike's condition. Satisfied, he slumped into his chair, then swiveled to the hazardous materials safe behind him. He turned back around holding a small biocontainer. Inside was a spider-like bug, several inches in length. It wasn't moving.

Kirk exchanged glances with Spock, who merely raised a single eyebrow.

"This is a Romulan arthropod," McCoy said. "Name escapes me for the moment."

"That's fascinating, Bones, but we came down here to get an update on Pike's condition, not to discuss Romulan entomology."

"Then you may be interested in a few facts about this little piece of Romulan entomology." McCoy nearly spat out the words. "Pike was forced to swallow it whole. Then it ate its way through the lining of his stomach and wrapped itself around his spinal cord."

Spock leaned forward to get a better look at the creature, eyebrow climbing toward his hairline.

Jim found himself gulping involuntarily but kept his eyes focused on McCoy. "And?"

McCoy's eyes flashed. "I think that's more than enough, don't you?"

"It is curious," Spock stated in a mild tone, "that the Romulans selected this form of torture. While unpleasant, there are other methods that are more . . . efficient in causing pain or even death."

McCoy appeared to relax slightly. "From what I've been able to determine, this thing releases a substance that acts as a truth serum. My guess is that they wanted information."

Given Nero's planned attack on Earth, McCoy's hypothesis made sense. "Did he give it?'' Jim asked.

"How the hell do I know?" McCoy reached for a glass of water. He really wanted coffee or, better yet, a stiff drink. "It's not important from a medical standpoint. What is important is that this thing also released neurotoxins into his cerebral-spinal fluid. From what I can tell, they've traveled to his brain and are wreaking havoc on his hypothalamus which, as you may remember from Biology 101, is the part of the brain that regulates body functions. Right now, Pike's are fluctuating wildly and there's not much I've been able to do to control it."

"Are there not medications . . . ?" Spock ventured.

"I don't need you to tell me how to practice medicine. He's getting the medications he needs and the fluctuations seem to be easing a bit, probably because removing the creature stopped any additional release of toxins." McCoy sat up straight. "But that's not my biggest concern."

Jim resisted the urge to ask the obvious question. Bones would get to it.

"I don't like the looks of the nerve conduction studies I've done."

Bones must have seen the blank look that creased his face. "Which means there may well be nerve damage," he explained.

"Paralysis?" Spock asked.

McCoy ran a hand through his hair. "Dunno. It's certainly a possibility. But until he wakes up and I can do more extensive testing, there's no way to determine the extent of the damage or even if there is damage."

"But the paralysis wouldn't be permanent, right?" Jim asked. "Aren't there nerve regenerator things?"

McCoy looked tired. "Jim, I did go to medical school. Even graduated. Yes, we can regenerate nerves, but there are certain baseline parameters that are needed for those drugs to work. This thing," he pointed to the container on his desk, "it's an unknown. I'm not sure what it's capable of and there's not much in our reference libraries to help. For now, I'm flying in the dark in terms of treatment."

When Spock failed to comment on McCoy's use of the idiom, Jim suspected that his First Officer recognized this wasn't the time to badger the doctor and that maybe the Vulcan understood human colloquialisms much better than he let on.

Spock stood up and reached for the container. "I will have the science department start an immediate analysis. We may be able to provide--"

He was interrupted by a shrill tone from McCoy's computer. "Goddammit, he's seizing!" McCoy bolted from his chair. Jim glanced at Spock, then followed his CMO into the isolation room.

Pike's body was jerking spasmodically, a medtech struggling to hold him down. McCoy glanced at the overhead monitors. "Cerisium, 500 milligrams!"

"What about his compromised respiratory status?" Collins asked.

"If we don't get this under control, he won't have a respiratory status. Get some C-14-B ready in case we need it."

Jim felt like a bystander, and a useless one at that, but couldn't pull himself away from the drama unfolding before him. If the medication was having any effect on Pike's condition, he certainly couldn't tell as the seizure continued. There were more reports from nurses and techs – a constant stream of readings and results, the success or failure of the current treatment. Jim couldn't follow the technical jargon but he could read body language as well as anyone. And the body language of the medical staff made clear that they were in a desperate fight for Pike's life and that they had full confidence in McCoy to lead them through it.

Finally, after what seemed like an eternity, Pike's body relaxed, the readings above his bed seemed to stabilize, and several of the medical personnel who had filled the room now drifted away. It had, Jim decided, been a humbling experience and yet strangely exhilarating. Not unlike the recent battle with Nero.

McCoy softly gave orders to his nurse then turned around, rubbing his temples, apparently not surprised to find Jim still there. "He's more or less stable for now. I really won't know more until he wakes up, and the meds I've given him will keep him out for awhile."

For the first time that day, Jim was aware of the doctor's scrutiny directed to him, Bones giving him the visual examination that he'd learned to despise. "Now, Acting Captain Kirk, it's past time I had a look at you." He nodded toward the adjoining room. "Let's go."

The last thing Jim wanted to do was face an examination. He had a pretty good idea what it would show and, given Bones' proclivity to overreact to every bump and bruise, that could well mean a couple of days as a patient in the medical bay. That's not what he or the _Enterprise_ needed. "Bones, I'm okay."

McCoy was having none of it. "I think I'm a better – and more unbiased – judge of that. CMO prerogative, _Captain_."

Jim started to argue, started to protest, started to deny. He looked at McCoy's determined face, looked at the still figure of Captain Pike, felt his own injuries increasingly making themselves known, and decided that this might not be the time to test the limits of his command or his friendship.

"Okay, Bones. But make it quick."

McCoy rolled his eyes. "I'm a doctor, not a short-order cook." He again pointed to the nearby exam room. "Go!"


	4. The Other Patient

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

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The fact that Jim hadn't offered more than token resistance to the exam spoke volumes about the extent – or at least the pain associated with – his injuries. Of course, Jim was like most Starfleet personnel McCoy had run across in the past three years in that he viewed a visit to medical as a sign of personal weakness. This attribute was so common among the command types that Starfleet Medical had designed a special course on just that subject. McCoy had taken it. A few more days with Kirk as Acting Captain and he'd not only be able to teach the course but write the whole damned book.

He pointed at the diagnostic bed. "Sit down and take off your shirt."

"I bet that line goes over well with your female patients."

McCoy smiled. "Medicine has its perks." In addition to the banter, there was a reason behind the request. Although his mediscanner could take readings through clothing, the act of removing a uniform tunic involved the use of multiple body parts and muscles and thus invariably caused the patient to reveal how seriously he was hurting. In Jim's case, the process elicited more than a few winces and at least one hiss.

"Feeling fine, my ass." McCoy couldn't help but grimace at the mottling of black, blue and red that covered Jim's torso. He stepped around the exam table to get a look at Jim's back – more of the same.

He grabbed a scanner from the bedside table, ignoring the evil glare from Jim, who hated the thing almost as much as the hypospray, probably because the scanner inevitably led to the hypospray. Starting at Jim's head, he slowly worked his way downward. Clucking sounds, punctuated by sighs, emerged from his mouth as the scanner reported its results. Individually, none of the injuries was life-threatening but the sheer number of them made him wince sympathetically with the pain Jim had obviously endured. He cursed himself for not seeing to Kirk earlier – yeah, he'd been focused on the more seriously injured Pike but in the future couldn't forget that the acting captain was always his primary responsibility.

McCoy put down the scanner and allowed his hands to probe Jim's injured neck and shoulder. In addition to seeing his patient's injuries, McCoy was a firm believer in the power of touch, both to diagnose and to comfort his patients. Unlike most patients, however, Jim was always restless beneath his fingers.

"Dammit, Bones. Enough already." Jim tried to push his hands away.

He just as insistently replaced them. "It's enough when I'm finished, not before. Now be still so I _can_ finish. I do have other patients, you know."

McCoy was rewarded with a scowl but at least Jim let him continue his examination. There was one last thing he needed to check. From the minute Jim had hoisted himself onto the exam table, he'd clearly been favoring his right side and now sat in a position that minimized pressure on his hip. "I want to take a look at your hip and then we'll be done."

"You've already scanned it. Come on, Bones, I'm Acting Captain. Busy man, you know."

No time like the present to lay down some ground rules. He crossed his arms and favored Jim with the stern chief surgeon face he'd used to terrify interns in Atlanta. "Scanners don't show everything. I want to _see_ it."

Jim glared at him, furious. McCoy met his eyes with a look that said, _not working_.

"You're a bastard, you know that."

_Yeah, that's what my ex-wife always called me_. To Jim, he replied simply, "So I've been told."

McCoy waited until Jim had positioned himself on his left side and pulled down his shorts, allowing him access to the injured region. Bruising went deep to the bone but, thankfully, no fractures, dislocation, or serious lacerations. Satisfied, he helped Jim sit up. "You'll live," he said, with a wry grimace.

Jim reached for his shirt. "Great. Then I'm out of here. Let me know when Captain Pike—"

McCoy pulled him back onto the table. "Not so fast. I said you'd live, not that you were fine. You need about two days of treatment—"

"Bones, I can't stay here." Jim's voice had taken on an almost pleading tone. "The _Enterprise_can't have both of its COs in medical. I've been doing okay so far – a little while more won't kill me."

"A little while more just might kill you." McCoy tried not to let his fatigue and exasperation creep into his voice. The only way to deal with Kirk when he started acting like this was to remain firm and tenacious. "Jim, your injuries need treatment. Without it, they're going to get worse and you'll spend ten days in here, not two."

"Can't we do this in my quarters?"

"What quarters?"

"Ha, ha. Don't give up your day job."

"I'm trying to do my day job." Still, Jim had a point. It wasn't great for morale to have both captains in medical and a first officer who was still reeling from the loss of his mother, not to mention his entire planet. And, while Jim's injuries needed attention, they really weren't life threatening – assuming he didn't get himself into more trouble until they healed. Maybe a compromise was in order. "I'll make you a deal. You give me two hours now to knit those broken bones. _And_ you agree to a mild sedative tonight."

"I can't be knocked out—"

"I said a _mild_ sedative. And you come back twice a day to continue your treatment until I decide you're sufficiently recovered." He shrugged. "Or I admit you. Take your pick."

***************************************

24 hours as CMO. Shit. He was too old for this. He'd joined Starfleet because, at the time, it seemed the best way to get as far away as possible from Atlanta, his ex-wife, her friends, his colleagues, and everything else that reminded him of his failed marriage. Some men dealt with mid-life crisis by having an affair or buying a hot new hovercraft. He'd fled the galaxy. Go figure.

True to his word, Jim had surrendered to medical treatment without too much complaining. McCoy had focused on the worst of it – knitting rib and phalange fractures as well as closing a couple of lacerations. At the end of exactly 120 minutes, Jim had demanded to be released. There was still more McCoy would have liked to do in terms of treatment, but at least he'd been able to make Jim's physical condition a bit less painful.

"Let me get you an analgesic for when those painkillers wear off."

"Forget it, Bones. Those things turn my head into a fog bank. And if you shoot me with one more hypo. . . ."

McCoy shook his head and held up a skin patch. "Not as good as the hypo but it will take the edge off. And it won't dull your obnoxious personality one bit."

Jim eyed the patch suspiciously but allowed it to be attached to his wrist. He started to ease his shirt over his head and seemed pleasantly surprised to find that his body was no longer a mass of pain.

"Treatment helped, didn't it?" McCoy asked smugly.

"Well, I assumed you weren't going to make me worse."

It was as close to a compliment as he 'd get. "They found quarters for you on Deck 4 -- 414B." He handed Jim a small vial. "Sedative. It won't knock you out – just help you get a decent eight hours sleep."

Jim had accepted it with the look of a man who had no intention of actually taking it.

"Jim, you will take that. The alternative is a hypo and a medical bay bed."

Much to McCoy's surprise, when he'd checked on Kirk later that evening, using the medical override to enter his quarters, he'd found the Acting Captain sound asleep. Sedative or not, the result was satisfactory.

Now, McCoy leaned back in his office chair and stretched. A quick glance at his computer revealed that all of his patients were asleep. Pike's condition had stabilized to the point where the nurses could handle the occasional blips in body functions. He judged that, based on the medications Pike had been given to date – probably only a few short of the entire onboard pharmacy – he too would sleep for at least the next eight hours.

Pike's neuro tests remained a source of concern. They weren't terrible; they just seemed "off." He'd be hard pressed to explain how or why; it was just a sense that something wasn't right – an impression based on experience. The science department had yet to come up with more information on the arthropod and McCoy wasn't a neuro specialist. He'd considered contacting the experts at Starfleet Medical but, until Pike was awake, there wasn't much he could say other than a CMO with 24 hours experience had a "hunch" that something was wrong.

McCoy took inventory of his "to do" list, starting with autopsies of crewmembers killed in the Romulan attack. Starfleet believed there was something to be learned from understanding how an enemy weapon penetrated the human, or non-human body. Glad somebody thought so. In McCoy's view, there wasn't much question what had killed them or much of them left to autopsy for that matter.

He needed to dictate surgical notes for Pike and review his staff's charting for the other patients still in the medical bay. Needed to update Kirk's file to reflect his injuries and treatment. Then there was the routine stuff – sanitation checks, arranging for grief counseling, and the daily medical report for the First Officer. He probably should have a staff meeting for what was now his staff. And probably another half dozen things that must not be too important because he couldn't think of what they were.

Most of it could wait. As the only MD aboard, he needed to take advantage of the fact his patients were sleeping to get some sleep himself. Pike would likely awaken in the morning and that would demand his full attention. He'd finish up surgical notes on Pike and medical notes on Jim, and still have time to grab dinner and a few hours of shut-eye.

The immediate question was where he was going to sack out. His assigned quarters were too far from the medical bay for his liking. Puri's were only a few doors away but he wasn't ready to sleep in his dead boss' bed. He'd have to get the quartermaster to find him a cot so he could sleep in his office. One more item on his list.

Right now, he could really use a drink. But Dr. Puri either didn't drink or didn't store alcohol in the office and he was too tired to go back to his cabin for his own stash. Better to go without it. He poured himself another glass of water and hit the dictation switch.

"_Medical Record for Pike, Christopher. Patient was admitted to the medical bay following rescue from a Romulan warship where he had been held captive for approximately 24 hours. Initial assessment revealed . . ."_


	5. Awakening

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

************************

"Dr. McCoy!" Collins called to him from the other room. "It's Captain Pike. He's waking up."

McCoy apologized to Ensign Rao, left a nurse to finish her vision evaluation, and within seconds was beside his most worrisome patient. After four hours of surgery and over thirty in a drug-induced sleep, the moment of truth had arrived.

Pike's eyes were blinking rapidly, head moving side to side, shoulders twitching. His lower body remained still.

"Feracol?" his nurse asked, asking if they should administer a stimulant that would speed the waking process.

McCoy shook his head. "Not yet. Let's see how he does without the meds."

Suddenly, Pike's eyes shot open with a look that McCoy could only describe as sheer terror. He gently rested a hand on Pike's upper arm – aiming for the balance between reassurance and restraint. "Captain Pike," he said softly.

Pike struggled to speak. "Pike." It came out in almost a whisper. "Seven." A pause. "Ent . . ."

"Captain Pike, you're on board the _Enterprise_. You're safe now."

Pike's eyes closed for an instant then shot open again. "Pike." It was said more vehemently this time. "Prize?" Then, without warning, Pike screamed.

The K-3 indicator revealed that Pike was in severe pain. McCoy pressed a hypo to Pike's jugular, the screaming stopped and the monitors confirmed the pain level was dropping.

"Captain. Captain Pike!" This time McCoy spoke more forcefully and slowly Pike's gaze fell on him.

"I'm Dr. Leonard McCoy. You're aboard the _Enterprise_, in the medical bay. It's been two days since you went over to the Romulan ship." Rule one: orient patients as to time and status.

Pike again tried to speak. "Pike . . . Ferkris."

McCoy swallowed a deep breath. Pike was obviously having trouble processing speech and seemed to be repeating bits of information he was permitted to give under interrogation, neither of which was a good sign.

Pike's gaze wandered toward the nurse. McCoy nodded encouragingly.

"Captain Pike, I'm Ensign Collins." She smiled broadly. "I've been taking care of you since you got back."

There was no reaction from their patient. McCoy mentally reviewed his options. There were drugs that should help clear the confusion Pike was experiencing. Drugs to help with neurotransmission, with motor skills, with memory. A goddamned pharmacy.

McCoy wasn't reticent about using the modern medications at his disposal. On the other hand, he'd seen too many patients overmedicated by doctors anxious to relieve symptoms before they fully understood what was wrong with their patient. And sometimes the very drugs designed to ease symptoms ended up masking important ones. He intended to proceed slowly and carefully.

"Captain Pike, can you tell me your first name?'

Pike closed his eyes, knitting his eyebrows in concentration. "Chhrriss," he finally said.

"Very good. And what is your rank?" Quick memory test since McCoy had just called him Captain.

Again there was intense focus. "Cap . . . tain."

McCoy smiled. "Excellent. Do you know where you are?"

"Ship."

"Which ship?"

"_Nero_."

"No, your ship."

"Prize."

McCoy smiled reassuringly to cover the lump forming in his throat. Like the rest of the crew, he liked and respected Pike, a commanding officer who was universally considered tough but fair. Starfleet had given him command of their newest and best starship for a good reason. Pike in turn had his choice of officers, which meant McCoy was aboard the _Enterprise_ because Pike had specifically requested him. And that decision was probably the one reason he was alive right now and not a piece of debris floating around the vacuum of space.

McCoy had seen his share of mangled bodies – patching them up is what he did best and he'd done his best surgically with Pike. Bodies could be fixed; brains, not so easily. It hurt to see a man who, three days before, had led a ship into battle now barely able to complete a word, let alone form sentences. And trauma surgeon and recently minted CMO Leonard McCoy had damned little idea what to do about it.

He folded back the sheet over Pike's right arm. "Captain Pike, move your right hand for me." He watched for any movement of the fingers or arm. Nothing. Damn.

"Come on, Captain, your right hand. Move your fingers." The fingers remained still.

"Doctor McCoy." Nurse Collins pointed at Pike's left shoulder. Realization dawned. McCoy didn't want to utter the words, knew what the result would be, but had to go on.

"Once more," he said, keeping his voice carefully neutral. "Try to move your right hand."

As he and Nurse Collins watched, Pike's left shoulder slowly moved up and down.

*****************************

Predictably, Jim called him an hour later. "Is Pike awake?"

"Come down here for your treatment and I'll fill you in."

"Bones, I've got to spend the day in engineering, see if there isn't a way to increase our speed."

"And you'll be a lot more effective _after_ you get treatment for those deep bruises."

When Jim asked how long the procedure would take, McCoy knew he'd eked out another small victory.

He watched as Jim made his way through the medical bay stopping by each bed. He greeted each patient by name, asked about their medical status, their jobs, whether they'd had a chance to notify their relatives that they were safe. The Acting Captin had done his homework.

Kirk's final stop was Pike's bed, where the Captain was again unconscious. "So?"

"So, Captain Pike woke up briefly an hour ago."

"And?"

"Honestly, Jim. I'm not sure."

"What do you mean you're not sure? Is he okay or isn't he?"

McCoy shook his head. "Definitely not okay."

"Explain."

"Let me get the treatment started and I'll explain." They moved into the next room where he motioned for Jim to lie down on the exam table.

McCoy ignored Jim's pained look as he positioned the apparatus over his right hip, seizing the opportunity to scan the rest of his body. "As I told you and Spock yesterday, that creature Nero introduced into Pike's nervous system left havoc in its path. He's suffering from severe pain and I haven't been able to determine the source. My guess – but it's only that – is that it's originating in the nerve fibers." He glanced at the monitors – Jim was in better shape than he'd expected. At least there was some good news.

"And," he continued, "the Captain is having trouble processing speech. He appears to understand what I'm saying, but has trouble formulating responses."

"Okay, so how do you help him?"

"I'm not finished. I told you that I had concerns about his neural responses. Based on my preliminary findings, I'm worried that his neural pathways are compromised."

"What the hell does 'compromised' mean? Why can't you doctors speak plain Standard."

McCoy rolled his eyes in annoyance. Did Jim think he liked the situation with Pike? Nero created this mess; he was simply trying to fix it. "To put it bluntly, Captain Pike can't control his body. The commands from his brain to his limbs aren't routing properly."

"Can you make him better?"

"I don't know."

Jim sat up from the table. "What do you mean you don't know? Are you a doctor or aren't you?"

McCoy bit down on his lip so hard he nearly drew blood. Of course he was a doctor. He was a damned good doctor who'd left a really good surgical practice to spend three years playing space cadet, only to nearly get killed on his first assignment. And, whether he wanted to be or not, whether he was qualified or not, he was also the fucking CMO of this ship. And right now, it all added up to zero in terms of helping Captain Pike. And he didn't need Acting Captain Jim Kirk to remind him of his own medical impotence.

"Jim, lie back down." His tone was sharper than it needed to be, which McCoy knew from experience would only further antagonize his friend.

"I don't want to fucking lie down. I want to know what you're going to do for Captain Pike."

"I know how much he means to you—"

"Don't give me that. He's the CO of this ship. He risked his life to save the _Enterprise_, Vulcan, Earth, and all of Starfleet, and you're telling me you don't know what's wrong with him or whether you can make him better?"

"I'm doing everything I can, _Captain_, to make Captain Pike well. However, I'm not a neurologist and this ship is not equipped to do extensive neurological testing or rehabilitation."

Jim glared at him for nearly a minute. "I want to see him the next time he wakes up."

"I don't think so."

"Well, I do."

"In my medical opinion, Captain Pike is not ready for visitors."

"Not even the Acting Captain?"

"Especially not the Acting Captain."

"Dammit, McCoy."

"Jim, right now Captain Pike is of no help to you and, quite honestly, I'm not sure he will be any time soon. There may come a point when seeing you will help _him,_ but it's not today. And until, in my medical opinion, your presence will benefit _him_, you don't see him."

"Bones, don't push me."

"This isn't about you. It's about doing what's best for Captain Pike."

Jim hopped off the exam table and this time McCoy didn't try to stop him. He turned at the door. "Very well, _Doctor_. I want a daily report on Pike's condition on my desk by 0700."

"You'll have it, _Captain_."


	6. Reality

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

The first feeling Pike recognized was the panic of rising through a swimming pool crowded with people, trying to push toward the surface of the water. It was immediately followed by abject pain, a fire that seemed to emanate from every inch of his body. Just as suddenly, the pain eased, lifted away as a blanket off a bed.

He'd been through Starfleet's program on enemy captivity – survival, evasion, resistance, escape – designed tried to prepare command personnel for situations such as he'd experienced on the _Nerada_. It sounded so easy in theory and even in the mock capture and pretend torture that highlighted the program. When the real capture and torture happened to him, the only trait of the four he'd apparently managed was survival. He was alive, sort of.

The last time he'd awakened had been terrifying. He couldn't turn his thoughts into words. Yes, dammit, he understood he was on the _Enterprise_, that Kirk had rescued him and brought him back. Yes, he knew his name, his rank, his serial number. Doctor McCoy – he still hadn't figured out why it wasn't Dr. Puri – was clearly concerned at his inability to respond articulately. So was he; you couldn't very well be a productive member of society, let alone a starship captain, if you couldn't voice your thoughts.

He was determined not to allow himself to fall back to sleep -- into oblivion where he could forget the failings of his body. This time, he needed to stay awake long enough to elicit a diagnosis and a prognosis from Puri.

"Captain Pike?"

He turned toward the voice. It was McCoy again. Odd.

"Are you having any pain?"

_You know I was which is obviously why you hit me with that hypo._ _And since I'm no longer screaming, you probably figure it worked._ "No."

"Do you remember who I am?"

_You're the guy who's probably stuck telling me that I'm going to be permanently incapacitated. _"Coy."

"Captain, I'm going to ask you some questions, ask you to do some things, so that I can map your injuries. It won't hurt."

_That's what the doctors always said, until it did hurt, and then they apologized as if the pain they'd just caused was one big surprise. _"K."

"I want you to start by reciting the alphabet."

_That's easy. abcdefghijklmnopqrstuvwxyz_. "H." _No, that's not right. A_. _God, how stupid I must look. Get it right, Chris. _"A . . . B . . . G . . . . no . . . P." McCoy's eyes remained glued to his while the nurse wrote everything on her PADD. This would look great on his next command review.

"That's fine," McCoy was saying. "Don't worry about it now; it'll come back."

_Sure it will. _

"I'm going to say the names of three objects. I want you to try to remember them because I'm going to ask about them later. The objects are: computer, shoe, apple.

_Computer, shoe, apple. Was there some logic to that choice? What mnemonic works for those? Computer, shoe, apple. _

"I'm going to touch your skin with a pin. Tell me if it's the sharp end or the dull end."

_He said this wasn't going to hurt and now he's sticking me with pins. _McCoy uncovered his feet. _Ow! Damn that hurt. _"Hurt."

_Why was McCoy frowning? And where the hell was Puri?_

"Captain Pike, where do you feel the pain?"

_Where does he think I feel it? _"Ear." _Oh, shit. No one's touching my ear. _

He tried to remain patient as McCoy stepped him through a series of tests – light, sound, touch, taste. The doctor was careful to control his reactions and Pike had trouble figuring out how he was doing. When the tests were over, he'd demand an answer, and ask to see Puri.

"Do you remember the three items I mentioned earlier?"

_Crap, what were they? Oh yeah, shoe, computer, apple. _"Foot. Fruit. _Why was it so hard to say three simple words? _"Apple." He was straining with the effort.

"It's all right, Captain."

_I am going to say these three words if it kills me. _"Shoe." _Computer, dammit_. It was too hard. He pointed at the nurse's PADD. _Computer. Computer!_

"Got it," McCoy replied with a smile. "That's enough for now. I think it's time for you to get some rest."

"Sults. Re. Sults."

"I know you want the results of your tests. I'll discuss them with you later, when I've had a chance to evaluate them and you're not so tired."

_Somehow, I don't think I'm going to win this argument. _There was one more thing he had to know. "K. Ate?"

McCoy and the nurse exchanged quizzical glances. "I don't understand."

_This is so frustrating. Where is Kate? Why isn't she here? _

"Kate. Where?"

"Dr. Puri? She's not here."

_I know she isn't here. Where is she? She's been my CMO for years; she should be taking care of me not some cadet three days out of the Academy._ _Why isn't she here? _

"There were casualties in the Romulan attack." McCoy was speaking again. "Dr. Puri was among them."

_No! No! No! McCoy, I was delivering bad news before you were born. I know the routine. Break it to them gently; allow them to absorb each piece before you make it worse. _She was dead. Kate was dead. _Oh, God no. Not you. Please, not you. Please, tell me this isn't happening._ "Dead?"

"Yes, Captain. She died in the attack, killed instantly. I'm so sorry."

McCoy was saying something else but he was no longer listening. It didn't matter. Nothing would change what had happened. Tears formed in his eyes and he was powerless to stop them from leaking onto his face. _Kate was dead. And how many others? How many of his crew had been killed?_

"Many?"

"We'll talk about it later."

He tried for his best command voice. "Now!"

"Later, Captain."

He saw McCoy nod, felt the familiar pressure of a hypo, felt himself falling into oblivion, as powerless to stop the freefall as he had been the tears.


	7. On Edge

PLEASE READ: This story is finished/completely written. However, my computer acccess over the next two weeks will be intermittent at best. So postings will be irregular and less frequent; however, I should be able to get the final chapters out within the week. My apologies in advance.

One minor note re the last chapter: I know the Alan Dean Foster novelization of ST 2009 has Dr. Puri as a male. However, it was only a fleeting reference and, for purposes of my story, I decided to make the characer female.

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

***************************************************

It was the next evening (and one signed and sealed 0700 CMO Report to the Acting Captain on the condition of one Captain Christopher Pike later) that a familiar voice sounded at McCoy's office door.

"Hey, Bones." Jim smiled at him as if they were still cadets at the Academy, as if nothing had happened between them in the past hours. "How about we grab some dinner?"

Still reeling from Jim's harsh criticism of his treatment of Pike, McCoy wasn't ready suddenly to make nice. "I'm sorry, sir," he replied formally, "but if you expect me to help Captain Pike, I need to study these neurostimulation treatment protocols."

"Cut the 'sir' crap, it doesn't suit you." Jim stepped into the office and leaned across McCoy's desk, his smile deepening. "You need to eat. And I'm hungry. So let's go."

McCoy reflexively gave Jim the once over using only his physician's eyes. Jim's energy level was high and few traces of his earlier injuries were visible. He'd always been a quick healer and this appeared to be no exception.

"Look," Jim was saying. "I'm sorry for yesterday. I'm just worried about Pike and I let it get the best of me. I know you're a good doctor and that you're doing your best for him." He grinned and held out his hand. "Truce?"

Sometimes Jim Kirk made McCoy feel like he was back on the grade school playground. It had taken a lot for Jim to make the first move; the least McCoy could do was to meet him halfway.

The mess hall was the best place on the ship to gauge crew morale. Or lack thereof, McCoy thought, surveying the somewhat dismal scene at dinner. Of course, having your closest friends blown to smithereens would ruin anyone's mood. Interspersed among the gloom, however, he overheard snippets of conversation about relationships, work, and even the sudden ascendancy of certain cadets to positions of authority onboard the _Enterprise_, suggesting that just maybe things were starting to return to some level of normalcy.

Although there was no formal hierarchy in the dining facility, junior crew and senior staff inherently congregated at separate tables. He and Jim collected their meals and approached a table where, not surprisingly, Spock sat alone.

Vulcans were vegetarians, McCoy knew, and he was somewhat curious whether Spock adhered to that regimen or allowed his human half the occasional steak. He made a mental note to check Spock's replicator card out of curiosity if nothing else. A quick glance at Spock's plate indicated that, for this meal at least, his Vulcan half had prevailed. It was easier to tell than it should have been because Spock's plate was still covered with food even though McCoy sensed that he'd been sitting at the table for some time.

McCoy decided to press the issue. "No matter what they say, Spock, replicator food doesn't taste like home cooking."

"Doctor, need I remind you that replicator food contains the same nutrients and chemical formulae as food prepared in a more conventional way."

He shrugged. "If it's so good, why aren't you eating it?"

Spock looked down at his plate as if seeing it for the first time. "I am . . . not hungry."

As McCoy looked more closely at the Vulcan, his medical instincts were on high alert. Spock seemed almost tense. And, while Vulcans could go days without eating when necessary, doing so without reason was unusual. McCoy mentally kicked himself. He'd been so focused on Captains Pike and Kirk that he'd forgotten about the strain on the First Officer, or the rest of the crew for that matter. As CMO, they were now all his responsibility. Then again, he'd always assumed that patients would come to him when they were ill or injured, not that he'd have to ferret them out and drag them in for treatment.

Kirk, who'd ignored the exchange, suddenly chimed in. "The energy level in here is in the tank. We need something to boost morale."

From McCoy's perspective, the battle with Nero had the unintended benefit of both taking the crew's minds off the death and destruction while the 'victory' had given them something positive to focus on. Now that the excitement was over, people had time to contemplate just how much had been lost. "They've been through a lot, Jim. They need time to process all that's happened and to grieve." He stole a glance at Spock, who had as much right as anyone to mourn. The Vulcan's gaze remained on his uneaten food.

"They can't grieve twenty-four hours a day. We need something, a distraction to take people's minds off of death and work for a few hours at least." Jim drummed his fingers on the table. "Needs to be something physical, maybe a sporting event – nothing like a good workout to take your mind off problems, right Bones?"

Before he could answer, one of Scotty's lieutenants approached Jim regarding an engineering issue. Jim excused himself and Spock too rose from the table in a movement that, in McCoy's opinion, lacked the Vulcan's usual grace. He'd seen enough.

"Commander Spock, I'd like you to drop by the medical bay this evening."

"For what purpose, Doctor?"

"I want to check you over."

Spock's eyes narrowed. "As a physician, you should know that Vulcans have an innate awareness of their physical well-being. I assure you that I am fully functional."

"Well you look like crap."

Spock raised an eyebrow. "An interesting medical term, Doctor. Are all your diagnoses so precise?"

McCoy lowered his voice so as not to attract further attention. "Spock, you've been through hell the past few days. Mental stress frequently manifests with physical symptoms. I'm _asking_ you to come see me; don't force me to make it a medical order."

Spock stood ramrod straight. "Very well, Doctor." If McCoy hadn't known Vulcans to be unemotional, he would have sworn Spock was angry. "You seem to have left me no choice in the matter." The Vulcan turned abruptly and carried his tray to the recycling station.

McCoy, now alone, picked at his food. At this rate, he was going to alienate the entire command staff by the time they reached Starbase. Maybe the problem wasn't that people were reluctant to come to medical, maybe it was his approach. What had worked his entire career didn't seem to be doing the trick out here.

At the Academy, medical cadets spent minimal time learning about the duties of the CMO as they would typically have years to observe their own CMOs before being given such responsibilities. He, on the other hand, had worked with Dr. Puri for less than a day. He was learning on the job and, from the looks of it, had a lot of learning still to do. Speaking of which, it was past time for him to get back to work – he dare not keep Spock waiting.

A voice from the next table caught his attention. "I heard Pike's really messed up." The source of the comment was an engineering lieutenant he didn't know.

"Yeah." He recognized Ensign Santorini from the micro lab. "My roommate's seen his chart; said his neurons are scrambled. Can't walk, can't talk."

"Is he going to recover?"

"Gentlemen." McCoy approached them from behind, voice like lead. "This is not an appropriate topic of discussion here or anywhere else onboard this ship. As Chief Medical Officer, I am responsible for the medical condition of this crew. If you have questions regarding the medical status of any crewmember, you will address them to me and only to me. Is that understood?"

McCoy turned around to find the mess hall absolutely silent, virtually every face staring at him. His little speech hadn't done much to improve morale and probably hadn't endeared the CMO to his future patients. At the moment, he really didn't give a damn. A member of his staff had shared information about Pike's condition with non-medical personnel. It was inexcusable. If Jim learned about it, he'd have McCoy's head, and rightly so.

********************************

His anger had only intensified by the time he entered the medical bay a few minutes later. He snapped at the first person he came across. "Beckworth, I want all medical personnel to report here within ten minutes."

"All of them Doctor? The early shift is sleeping—"

"Everyone. Ten minutes. They do not want to be late."

"Should they report in uniform?"

"I really don't give a damn."

Nine minutes later, his staff stood outside of his office, shuffling in place and trying to decide whether to stand at attention. A summons from the boss at this hour could only mean he wasn't happy. And that was putting it mildly.

He allowed his gaze to rest briefly on each staff member. "I just came from the mess hall where crewmembers were discussing Captain Pike's medical condition." His tone reflected a barely contained fury. "Every patient, from the most junior crewmember to the Captain of the ship, will be treated with complete confidentiality. That means no one discusses any aspect of any patient's condition with anyone other than medical personnel – not your friends, not your roommate, not your lover. If it happens again, I assure you that I will find the person responsible and ruin not only his Starfleet career but his medical career as well. Do I make myself clear?"

Without waiting for replies, he turned on his heel and strode toward his office. And nearly ran headlong into Spock.

"Is there a problem, Doctor?"

"Just a personnel issue." He forced himself to relax and pointed toward the open exam room. "I'm all ready for you."

"I assure you, there is no need—"

"Humor me. It's been a long day."

"Doctor, I do not believe my responsibilities as First Officer include providing comedic relief to the Chief Medical Officer. And, I would point out that all days are twenty-four standard hours—"

McCoy raised his hands in submission. "I get it."

McCoy waited until Spock had reclined onto the exam table. "Privacy." The computer responded by turning the glass walls of the room opaque, allowing no one to see out or in. McCoy slowly ran the scanner over Spock's still form. Human patients typically liked to "chat" during exams; McCoy sensed that, with his Vulcan patient, the less said the better.

"May I inquire as to the condition of Captain Pike?"

Hmm. Maybe he'd been wrong about chatting, or maybe Spock had overheard his tirade about patient confidentiality. "As the First Officer you have every right to know his medical condition." McCoy frowned. Spock's hybrid anatomy was throwing up some odd readings. He made a few adjustments to the equipment. "He's largely unchanged. I've come up with a possible treatment that I hope will improve his verbal processing. I'm going to discuss it with him in the morning."

"You seem somewhat uncertain. Is there risk?"

McCoy sighed. "We're dealing with the byproduct of an alien life form about which we have very limited information. There's always risk."

Spock simply nodded and closed his eyes.

McCoy made quick work of the remainder of the exam. "Okay, Commander, we're done."

Spock pulled himself into a sitting position. "Am I free to leave."

"Don't you want to know the results?"

"I expect you have confirmed that I am fully functional."

McCoy crossed him arms. "Your blood pressure is elevated."

Spock frowned. "Undoubtedly due to my human biology."

"I accounted for that. It's still too high." McCoy noted with amusement how Spock gazed with disdain at the hypospray on the nearby table. "Spock, there are drugs that will help, but I'm not going to prescribe anything right now."

"Your approach seems quite in contrast to your treatment of the Acting Captain."

McCoy couldn't help but grimace. He _had_ probably overdone it with the hypospray on the first day aboard. "I know how the drugs will affect humans and have a pretty good idea how they'll affect Vulcans. What I don't know is how they'll affect _you_ and, until I'm sure, I'd rather not use them."

"Such restraint is most welcome, Doctor."

"I understand Vulcans have ways of helping their bodies heal naturally – meditation and the like. I suggest you try those."

"I shall do so."

"And, I want to see you back here every few days. Hypertension in Vulcans can be serious. So, if your techniques don't work, we'll have to try the meds. Understand?"

"Understood."

Understood? No argument? Would that green-blooded bastard ever cease to amaze him?


	8. Complications

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

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"Captain Pike," McCoy was saying to his patient early the next morning. "I want to make sure you understand. I think this treatment will work. But it has risks. I'm not a specialist in neurotransmission, so I may be off-base here. And, everything about this creature to date has been unpredictable so I can't be sure that, even if everything works in theory, it will work in practice."

"On. It."

McCoy smiled. By now he'd learned to decipher Pike's cryptic comments. The Captain was telling him to get on with it. "I will, sir. One more thing. _If _the treatment is successful, it should make it easier for you to communicate; it's not a complete cure and won't help with the sensory issues or the paralysis."

Pike's condition had continued to evolve. The nerve pain had decreased on its own, such that McCoy no longer needed to ply him with analgesics every time he awakened. In its place, another, more sinister symptom had emerged. Pike was now experiencing occasional paralysis affecting different parts of his body at different times. Suddenly, and without warning, he would lose sensation in his right lower leg, or his left fingers, or his facial muscles. It could last anywhere from a few seconds to hours. And then, just as suddenly, the feeling would return. The severity and unpredictability of the problem had both Pike and the medical staff on edge.

"Not sue."

McCoy exchanged an amused glance with his nurse. Pike wouldn't sue them! If the character of a man was measured by the way he faced adversity, Pike was approaching sainthood. Less than a week ago, he'd been one of the most powerful men in the universe, commanding the finest ship in Starfleet. Now, even though he couldn't feed himself, use the bathroom, walk, or even complete a sentence, he rarely complained.

McCoy had already tried the standard treatments for aphasia without success, probably because they weren't intended to treat speech processing issues that resulted from Romulan arthropods. He now believed that toxins from the creature had infiltrated Broca's area, or the speech center of the brain. He planned to introduce a chemical compound into the same area in the hopes it would bind to and neutralize the toxins. McCoy didn't even want to think of all of the things that could go wrong with his plan. Sure he'd explained the risks, but he'd explained them to a desperate man. As Pike's doctor and CMO, the decision to proceed was his.

"Let's get started."

Pike was awake for the procedure, given a local anesthetic before the probe was inserted into the brain. McCoy kept one eye on the monitors as he slowly introduced the chemical.

"Spinal pressure is rising, Doctor," Collins reported.

It was a predictable side effect. He kept going. "How are you holding up, Captain?"

"Warm."

He'd already explained to Pike that a warm, flushed feeling was to be expected when the chemical was introduced. Now he repeated that explanation.

The procedure was over quickly and the probe removed. The moment of truth had arrived. "Tell me your name," he said to Pike.

"Cap. . .Cap." Pike sighed in frustration. "Pike." He shook his head. "No. Work."

McCoy forced himself to meet Pike's eyes. The sadness in them was physically painful. McCoy tried to project an optimism he didn't feel. "It's too early to tell whether it's worked. Let's give it a little time."

Pike seemed to sense his despair. "Not. Fault."

Not his fault. If it wasn't his fault then who the hell's fault was it? It was all he could do not to toss every piece of medical equipment against the nearest wall. Damn, damn, damn. He'd been so sure he was on the right track. His experiment had failed and he had no earthly idea what else to try.

"See Kirk."

Pike was right. It was time, time for Jim to see for himself what had become of Pike and the limits of his own skills as a physician.

"Nelson!" He called over one of the medtechs. "Let Acting Captain Kirk know that Captain Pike is ready to see him."

"Doctor! Respiratory distress!" The nurse's voice, the shrieking of the monitors, and Pike's grabbing for his throat all competed for McCoy's attention. _Sonofabitch!_

"Belay that! Get a team in here, stat!" Pike couldn't breathe.

McCoy and the nurse moved by instinct, their reactions sharpened through years of dealing with respiratory emergencies. As he attached leads, administered medications, and provided breathing assistance, his mind raced. Had his novel treatment caused this or had the paralysis simply manifested itself in Pike's respiratory tract?

"Respirations 15, assisted," the nurse reported. "Vital signs stable."

"Let's run another series of neural transmission tests. See what we're dealing with." McCoy looked down at Pike's unconscious form. How much more of this could they all take?


	9. A Reluctant Patient

.**NOTE**: As I mentioned earlier, I realize Dr. Puri was referred to as "he" in both the movie and book. However, since he didn't get much screen time :), I decided to make the character female because it worked better for my story. I apologize to the purists (no pun intended).

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

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Two hours later, Pike was breathing on his own, as if the emergency had been merely a bad dream. McCoy decided to let him sleep. He'd been through enough today; the least McCoy could do was give him additional energy – and time – to face the future.

He jotted down some notes for the afternoon medical staff meeting. Physical exams for incoming crew – himself included, he noted with irony – still needed to be completed. He had to check on where his staff stood in term of their Professional Qualification Standards. He probably should pull the ones for CMO – see how he was doing. There was required crew first aid training to organize, a simulated mass casualty drill to run. They'd already done the real thing but Starfleet had its rules.

He checked his chronometer. Twenty minutes until the department head meeting Jim had called. He hadn't more than glanced at the invite and hoped he hadn't been tasked with some presentation he hadn't prepared. The daily report on the status of all patients was two days behind. The duty schedule needed to be approved. And he should follow up with Jim from a medical stantpoint to make sure all the injuries really had healed.

And then there was Captain Pike. They'd be at Starbase 17 in four days and, for all his ministrations, the Captain's condition wasn't much changed. McCoy couldn't help but wonder if there wasn't something else he could have, should have, done.

"Need some help here!"

Through the glass walls of his office he saw Ensign Ngo brought into the medical bay supported by two colleagues from engineering. He still didn't know most of the crewmen aboard the _Enterprise_; Ngo he knew only too well.

He was at their side in an instant, guiding the group to the nearest exam room. "What happened?"

"Keeled over," one of the men replied. "Said her stomach hurt. We brought her right here."

He decided not to berate them for transporting an injured crewmember without first consulting medical; that would be topic one for the next first aid training. After dismissing the men, he focused his attention and his scanner on his patient. Nurse Collins entered the room as he started his examination.

"Lisa, when did the pain start?"

"I'm okay."

_Yeah, that's why you were half-carried to the medical bay. _What was it with folks on this ship? Why would no one admit to feeling ill? No fever, vital signs okay. Abdomen was normal. He continued scanning. It didn't take long to get an answer, one that neither he nor his patient was going to like. He clicked off the scanner.

"Lisa, it looks like you have an ovarian cyst." GYN issues were something he hadn't dealt with since internship other than a short course at the Academy. Shit, he was expected to be an expert on everything. "I need to do a more complete exam."

She didn't even look at him. "Forget it."

He did not have the energy for this. "Sorry, not an option."

"I don't want you examining me."

Of course she didn't and he had a pretty good idea why. He exchanged a quick look with Collins who seemed somewhat surprised at the development. "Nurse, could you give us a minute."

"Of course, Doctor."

The instant she left the room, Lisa was on him. "Leonard, I can't do this. I'll see a nurse or whatever, but not you."

This is why Starfleet assigned two physicians, usually of different genders, to each starship. It gave patients at least some choice. Fate in the form of Captain Nero had taken that choice away from Lisa Ngo.

_Would you stop acting like a child and let me do my job? _is what he wanted to say. What he did say was, "I understand. But you need to be diagnosed by a doctor and right now I'm the only doctor on this ship." Stay calm and understanding, he reminded himself. Bedside manner 101.

"Leonard, we're friends. We dated, for god's sake."

Platonically, McCoy reminded himself. "Lisa, I'm a doctor. My job is to take care of people when they're sick. That's all I'm trying to do here."

"I can't do this."

"You have to do this."

"We're almost to Starbase 17. Just dope me up until we get there."

"I can't just dope you up until I know what's wrong with you. If it's a cyst, I can take care of it in less than an hour. You'll be back in your room by bedtime."

"No."

McCoy took a deep breath and slowly exhaled. Civilian patients had the right to refuse treatment. Not so in Starfleet. As CMO, his word in medical matters aboard ship was law. He hated himself for what he was about to say. Medically, he was spot on; as a human being, he was being a total jerk. "Lisa, I know you don't want me to be your doctor. But as CMO, you're my medical responsibility and I have to do what I think best for you. It'll be a lot easier for both of us if you cooperate."

In the end, he'd completed the exam, which revealed what he'd expected. The surgery was straightforward and effective. Lisa Ngo had been released from medical a few hours later, physically healed and still furious with the CMO.

McCoy sat in his office, dictating the surgical notes. Once he'd finished, and made rounds, he could return to his cabin and maybe get a full night's sleep for the first time since he'd taken over as CMO. The very thought of a darkened room, crisp sheets, and a warm blanket was intoxicating.

"Doctor McCoy?" Nurse Collins leaned against the doorframe.

He couldn't help but smile. "Come on in."

He looked her over critically. Collins had almost single-handedly cared for Captain Pike since he'd been brought into the medical bay and it was starting to take its toll. She looked exhausted. McCoy reminded himself to make sure she and the other members of his staff got the rest they all desperately needed.

"Doctor McCoy, Ensign Ngo is a friend of yours, isn't she?"

"Sit down, Collins." He gestured to an empty chair. "Yes, she is." _Or, after the events of today, was._ "Three years at the Academy. We studied together, even dated a few times."

"And you're friends with Captain Kirk."

He grinned. "Sometimes."

"Permission to speak freely, sir."

"Only if you stop calling me 'sir.'"

She favored him with a smile. "Sir – Doctor. You've only been onboard a few days. This is my third tour on a starship. Trust me, after a few weeks, you'll know all your patients. You'll eat with them, go on away missions with them, work out with them, drill with them. At some level, they'll all become your friends."

"And your point?"

"I know it was difficult for you to treat Ensign Ngo. With all due respect, get used to it. On this ship, you're their doctor, whether they like you, trust you, or couldn't give a shit. If they want a choice of doctors, they can go back to Earth."

"Patients have the right to choose—"

"Bullshit. Excuse me, sir – Doctor. On this ship, the only right they have is the right to first-rate medical care. You give them that and a heck of a lot more. The fact they don't want to undress for you, or show up for their appointments, or let you see their psych profiles is too damned bad. And if you let them get away with it, even a little bit, you'll be useless as the CMO." She smiled. "Sir."


	10. Improvement

Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

**************************************

"Doctor." Nurse Beckworth greeted him the minute he walked into the medical bay the following morning, feeling refreshed after a solid six hours sleep. He'd arrived early in the hopes of catching up on paperwork before morning sickcall. They were only three days from Starbase 17 and, by the time they arrived, he needed to have everything in tip-top shape.

"How is our prized patient this morning?" He assumed Pike's status was relatively unchanged because, if there'd been any major developments during the night, the duty nurse would have called.

"In good spirits, although the rotational paralysis is continuing. I'm not sure the Pyrodine is having much effect."

"Then let's discontinue it. I don't like the strain it puts on his liver and if it's not working . . . ." McCoy shook his head. Another brilliant idea gone down in flames.

"Captain Pike wants to see you."

Of course he did. What was he going to say? Sorry, Captain, I did my best but you still can't move various body parts and still sound like a two-year-old?

He swallowed hard and took a deep breath before entering Pike's room. He was Pike's doctor. He was, for better or worse, the CMO. Time to face the music.

"Captain Pike," he said formally. "Good morning."

Pike was smiling. "Good morning. Doc . . . tor McCoy."

Did he hear what he thought he'd heard? "Say that again."

"I want to . . . tell you. Your treat . . . ment. I think it worked. Thank you."

Leonard McCoy had never cried in his life. Not when his father died. Not when children died under his scalpel. Not when his wife had left him. Hearing the words coming from Pike's mouth and seeing the boyish grin back on his patient's face brought tears to his eyes.

***********************************************

"You cured him," Jim was saying.

McCoy and the Acting Captain were watching a boxing match between Ensigns Pavel Chekov from Command and Joe Dupree from Science. Jim had gotten his wish for an athletic event that would, they all hoped, bolster crew morale. At Jim's direction, Lt. Sulu had organized what was actually a series of events – boxing, fencing, martial arts – pitting crewmembers from different divisions against each other in friendly battle. To the victors would go bragging rights and extra shore leave when they reached Starbase 17.

"Cured who?"

"Pike. He said you cured him."

"I appreciate the vote of confidence, but Captain Pike is far from cured." McCoy kept his voice low. "Hopefully, they'll be able to do more for him at Starbase 17."

"Well, at least he can carry on a conversation, which is more than he could do two days ago." Jim's gaze returned to the ring where the final match of the evening was playing out. "Chekov looks pretty good, doesn't he?"

It was killing Jim to be sitting on the sidelines, and he was there only because McCoy had finally managed to convince him that the Acting Captain was supposed to watch the event and support his crew, not get his own face beaten to a pulp. In fairness, Jim was more than a decent boxer, combining natural instinct with the formal training they'd received at the Academy. He'd nearly been the class boxing champ; he'd made it to the finals only to lose on points to a larger and more experienced opponent after giving the guy all he could handle and then some.

"He's certainly holding his own." McCoy was knowledgeable about the sport, even if his personal athletic tastes went more to distance running.

The opponents were evenly matched, and their aggression soon had the onlookers rooting heavily (and betting heavily, McCoy suspected) on their favorite.

The bell rang, signaling the end of the second round. From where he sat, McCoy had a good view of both fighters. He would do his best to stay out of it. Minor cuts and bruises could easily be patched up later; the referee and trainers knew he was there and would alert him to any serious medical issues.

Sixty seconds later, the combatants were back at it and, knowing it was the final round, both men were giving it their all. Chekov saw an opening and pressed his advantage, pushing his opponent back into the ropes and pummeling him with punches. The crowd became even more excited.

Chekov must have gotten too cocky and let down his guard, and his hand, because suddenly Dupree's right arm swung out, hitting him squarely in the chin and sending him flying back onto the canvas. The referee immediately pushed Dupree toward a neutral corner and started the mandatory ten-count, audience counting along with him.

He'd only reached the count of "four," when Dupree unexpectedly rushed back to where Chekov was slowly rising to his feet and began punching him again, sending him back to the canvas. Chekov, unprepared for the attack, tried his best to cover up even as Dupree continued to pound his head into the mat.

"Dupree, get off him!" The referee reached for him, trying to pull him away.

_What the hell was going on?_ McCoy grabbed his medikit and pushed his way toward the ring, Jim right beside him.

The referee and trainers managed to pull Dupree away from Chekov. Dupree's face was red, his eyes wild. "Let go of me. Let me at him. It's his fault. He killed her."

"Easy, son," McCoy said, doing his best to diffuse the situation.

"Dupree!" Jim called is his strongest command voice.

It had no effect. Dupree continued to strain against the men holding him, still screaming at Chekov.

McCoy had had enough. He pulled a hypospray from his kit and set it. "Hold him still!" Somehow he managed to find an exposed patch of skin on Dupree's neck. A hiss later, Dupree collapsed like a sack of potatoes. "Take him to medical and put him in restraints. Tell them I'll be right there."

Chekov, who had been helped to his feet, was wiping blood from his nose and lip. McCoy stepped closer and lifted Chekov's chin with his fingers, studying the injuries. "You'd better come along too, Chekov. Some of those cuts will need to be closed."

The navigator looked reluctant.

"Go on, Chekov," Jim prodded in an unexpected show of support, then pulled McCoy aside.

"What happened to Dupree, Bones?"

He shrugged. "Don't know. I'll check him out, see what I find." With Chekov in tow, he headed back for medical.

Behind him, he could hear Jim's voice. "All right, everyone. Show's over. Let's get back . . . ."

**********************************8

Several hours later, McCoy poured two glasses of scotch and pushed one across his desk toward Jim. "Here."

"Thanks, Bones." Jim took a hefty sip. "Whew! You brought out the really good stuff."

"Only the best for the Captain." McCoy took a sip from his own glass, the liquid sliding down his throat. It was the first alcohol he'd allowed himself in days and, truth be told, he'd missed his evening nightcap.

He and Jim were camped in McCoy's office, feet propped up on his desk. It was late in the evening and the medical bay was quiet.

"How's Chekov?"

"His face is beautiful as ever," McCoy replied with a smile. "Just some facial lacs – nothing serious. In a couple of days, you won't even know he was hit."

"And Dupree?" Jim gazed through the glass office walls to where the young Ensign lay asleep on one of the biobeds.

"From what I've been able to piece together, his fiancée was aboard the _Farragut_." Which meant that she was dead, killed in the battle with the Romulans. "For some unknown reason, he transferred his anger at Nero to Chekov."

"Will he be okay?"

"I think so. I'll do some therapy with him in the next couple of days. Starbase 17 has a great psychiatric staff; he'll get the best of care."

Jim took another sip from his glass and let it settle in his mouth a few seconds before swallowing. "Guess the boxing match was a bad idea."

"On the contrary, it was a great idea. From what I've heard, it was exactly what people needed."

"Like Dupree?"

"Jim, he has some serious psychological issues. If they hadn't manifested themselves tonight, they'd have come out some other time when the damage he caused might have been a lot more severe than a few cuts to Chekov's face."

Jim's eyes roamed the small room. "It still looks like Puri's office."

"Yeah, my nurse said the same thing. But I can't bring myself to put away her things. And, besides, who knows how long I'll be the occupant."

"Planning on going somewhere?"

"You know Starfleet's offering transfers." The _Enterprise_ would be in space dock while repairs were made to her warp drive. For that and other reasons, Starfleet was at least considering reassignments for some of the crew.

"Are you going to put in for one?"

McCoy poured himself a bit more scotch. "I'm thinking about it."

The response clearly surprised Jim, who dropped his feet from the desk and leaned forward in his chair. "You're joking, right?"

"No, Jim, I'm not. Look, I'm a surgeon; putting bodies back together again is what I do best. This," he gestured around the office, "isn't me."

"Where would you go?"

"Maybe where we're headed. Starbase 17. It has the best medical facilities outside of Earth, and a huge surgical department that handles some of the toughest cases."

"Bones, I need you here."

"That presupposes _you're_ going to be here."

"Touché."

"I haven't made up my mind. I'm just not sure this is where I belong."

"Promise me that if they don't court martial me and if, by some miracle, I end up as Captain, that you'll at least consider staying."

"That's a lot of 'ifs.'"

"Bones!"

"Okay, I'll consider it." Jim's glass was empty. McCoy held up the bottle of scotch. "More?"

"No, thanks." Jim stood up. "Time to call it a night."

McCoy raised his glass. "Night, Jim."


	11. A Summons and a Decision

A final HUGE thank you to Ceri for the great beta. **PLEASE READ NOTE AT END OF THIS CHAPTER.**

Disclaimer: Would love to own ST, but I just borrow the characters and return them intact

***************************************

McCoy checked his uniform for the fifth time. A summons to the quarters of Starfleet's Surgeon General was like being called to the principal's office – it probably wasn't good news.

_Enterprise_ had arrived at Starbase 17 two days ago. Captain Pike had been whisked away by experienced hands and McCoy had suddenly found himself with little to do other than catch up on paperwork. Until, that is, he received notice to report to the Surgeon General's office. No explanation given.

He gave a final check of his uniform and chronometer then pressed the bell announcing his presence. The door opened. As he'd been trained at the Academy, McCoy took two steps into the room and came sharply to attention. "Lieutenant McCoy reporting as ordered, sir."

Surgeon General and Admiral Elise Waylan stood at one of the large picture windows that overlooked the sprawling facility. Second in size and scope only to the medical facilities on Earth, Starbase 17 represented only a fraction of her command. There were medical outposts of one size or another at every Starbase, a fleet of medical support ships, hospitals, rehab facilities, training centers – she was responsible for a small army of medics and a plethora of medical facilities throughout the universe.

Since receiving the summons, McCoy had familiarized himself with Dr. Waylan's background. She was a neurosurgeon by training, having come to medicine only after a stint as a helmsman where she'd distinguished herself in several armed conflicts. There were rumors that she'd once been a Starfleet spy. For reasons not fully explained, she'd transferred to Medical, served as CO of medical scout ships _Respite_ and _Relief_, CMO of the _Intrepid_, and then moved to HQ where she'd quickly risen up the ranks.

Still, her recent promotion to Surgeon General had come as a surprise, and many in the old guard criticized the decision saying she lacked "experience," which, in McCoy's opinion, meant only that she wasn't one of them.

She turned from the window, revealing a tall, willowy woman, with dark hair that reached just her shoulders. Her face was severe, almost aristocratic and yet there was a certain playfulness in what had to be the darkest eyes McCoy had ever seen. He knew Waylan to be in her early 50s; she could easily pass for a decade younger.

"Doctor." She nodded formally. "I expect you are curious as to why I requested to see you."

McCoy grimaced. "The thought had crossed my mind."

"Relax, Doctor. At ease."

McCoy tried to convey alertness and respect while forcibly relaxing his muscles. It was hard.

"I understand you've requested reassignment to Starbase 17."

"Yes, sir." He started to explain his reasons then thought better of it.

The brown eyes appraised him carefully and McCoy resisted the urge to check once again that his uniform was in order. "Why?"

_Well, since she'd asked . . ._ "I believe that my skills would be put to better use in a surgical environment."

"Do you now?" She came around the front of her massive desk and pointed with an open palm to the small sitting area. "Please, sit down."

He dropped onto the settee, perched on the edge. Then, deciding he looked like a mischievous schoolboy, did his best to relax into the cushions. When he looked up, Waylan was already seated across from him, managing to look completely relaxed and yet totally in control at the same time.

"You did an excellent job with Captain Pike."

"I did my best. But as you know, I'm not a neurological expert—"

"Well, as _you_ know, I am." She smiled and McCoy couldn't help but feel like the mouse looking into the face of a hungry cat. "I reviewed your notes of his care very carefully."

McCoy gave thanks for the fact that he'd finished them before they arrived. From a purely professional perspective, he was anxious to hear what he should have done that he hadn't done.

"I will tell you Doctor, that there is not one thing that you did that I would have done differently."

_Really?_

"Well, there was one thing." That mischevious smile was back.

_Uh-oh, here it comes._

"I'm not sure I would have tried the benzotrexate compound you used to restore some of the Captain's vocal pathways. That was inspired, Doctor. truly inspired."

What did he say to that? Nothing came to mind. Finally, he grew uncomfortable with the silence. "How is Captain Pike?" He'd heard that Waylan had come out to Starbase 17 in part to take personal charge of his care. Word had it they'd long been close friends . . . and maybe more.

"Better than he has a right to be, thanks to you."

"Will he walk?"

"I hope so." Her eyes held his and only a slight tightening of her jaw revealed the level of her concern. "There's a lot of cord damage and the paralysis is troubling, but there are a few things I want to try that may help." She favored him with a tight smile. "In any event, he has a long recovery ahead."

Again, McCoy decided to keep quiet. She'd called this meeting; best to let her take the lead.

"Back to your request for a transfer," she continued smoothly. "I must tell you that I intend to deny it. However, given your performance onboard the _Enterprise_, I felt that I . . . owed you an explanation." She pressed a small button at her side. Within seconds, a yeoman appeared. "Doctor," Waylan asked, "would you like something to drink?"

_Yeah, a double scotch would be great right about now._ "Water would be fine."

"Make that two." After the yeoman left, she turned back to him. "I became Surgeon General three months ago. In that time, I've decided that Starfleet's best doctors aren't where they should be." She gestured toward the window. "Out there, on ships with the fleet. Too many of them are in places like this, sucking up to people like me, hoping to be people like me.

"It's wrong," she continued. "Our men and women on the front lines deserve the very best care. Men like Captain Pike. In the hands of a lesser physician, there would be no hope of improvement; he might have even died. What you did in administering the benzo compound is exactly what I want to see."

"It might have failed." Shit, he'd opened his mouth.

"Yes, it might have and that might not have helped your career. But it was a calculated risk in a situation where doing nothing meant certain failure. Doctor, I need physicians in the field who can make those decisions, doctors who are willing to take risks in doing what's best for their patients, even at the expense of their own careers."

This time he managed to keep his mouth shut.

"So I've decided to assign our best to the Fleet as CMOs, starting with you, Doctor."

"I'm uh—"

"Unhappy, probably." A half–smile played on her lips.

The yeoman returned, and Waylan was silent until the water was served and the yeoman had excused himself.

"I won't give you a choice about going to the fleet, but I will give you some choice in the matter. You've earned that much. You can stay as CMO of the _Enterprise_ or, if you prefer, I'll assign you to the starship of your choice."

A Hobson's Choice if he'd ever heard one. "Permission to speak freely, sir."

Another smile. "Always, Doctor."

"I appreciate your confidence in me. But I don't think I'm cut out to be a CMO."

"Captain Pike certainly thinks you are."

"I'm a surgeon and a good one. Beyond that, I had no idea what I was doing out there. It was like flying blind. Half the crew probably hates me—"

"You're there to be their doctor, not their friend."

Kind of what Collins had said. "I didn't know the first thing about what I was doing, or even supposed to do."

"Considering you had no starship experience, no training in the duties of CMO, I consider your performance admirable. Other than, perhaps, the little mishap with Cadet Kirk."

He'd been afraid that would come up. He braced himself for a reprimand.

"Don't worry. We offer a course for prospective CMOs. I teach it, so I think I can probably get you in."

Damn, no reprimand for his little stunt with Jim. And, the Admiral had a sense of humor.

She took a sip of water. "Don't forget that I've been in your shoes. I know from personal experience that the job of CMO isn't easy. But in my opinion, it's the single most important job in Starfleet Medical and, as I said, deserves the very best we have."

"Admiral, with all due respect, I think that—"

"Doctor McCoy." Her voice was like quicksilver. "You forget one thing."

No doubt she'd tell him what that thing was.

"This is Starfleet. No one gives a damn what you think. The advantage of being an admiral – and Surgeon General – is that people do," she pointed at her epaulets, "care a great deal about what I think. And I think – no, I know – that you belong as CMO of a starship. Now, the only question is whether you want to stay on the _Enterprise_ or move to another ship. _Enterprise_ will remain at Starbase 17 for another seven days."

How did she know that? Even Jim didn't know how long they'd be here.

She was still talking. "I'd like to have your answer before the _Enterprise_ departs."

"Who will be commanding the _Enterprise_?" Crap, he'd opened his mouth again.

"An interesting question, Doctor." She gave him another tight smile. "What makes you think I would have this information?"

_Because I think you know quite a bit about a lot of things. _"Just a hunch, Admiral."

She rubbed her hands together. "Let me say this. Captain Pike thinks very highly of Jim Kirk, and his views on this subject . . . carry great weight."

So, maybe Jim wouldn't be court-martialed after all. Shit, if Jim was going to be on the _Enterprise_, someone had to be there to clean up after him. _Might as well be me. Who else could handle him?_

"Then I don't need a week to make my decision. I'll stay where I am. I just hope you don't regret my decision."

"Doctor, I'm confident of my decision and yours. And, to date, most of my decisions have been correct." She stood up and he jumped to do the same. "You'll be receiving your orders and your promotion to Lieutenant Commander by the end of the day." She held out her hand. "Good luck, Doctor."

He exited Waylan's office and the headquarters building. He was headed back to the _Enterprise, _back to Jim and probably that pointy-eared hobgoblin as well. Back to Collins and Beckworth and an office that would now truly be his. Back to being responsible for the lives of 500 men and women whom he would soon call his friends. Oh, what the hell. Back to his future and whatever it would hold.

~End~

**NOTE**: Thanks to all of you who took the time to submit a review -- your comments were much appreciated. For those who enjoyed this story, another is on the way. It will be a follow-on to Complications, but not a sequel per se. Look for it in about a month.


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